This invention generally relates to a healthcare communication and workflow management system and method. In particular, the invention relates to a system and method for integrating a wide range of health care organization workflow management functions, generated by automated systems, manual and automated events associated with patients and staff interactions through input-output devices such that requests and dispatch requests can be handled locally or over a widely distributed network, and can be tracked and escalated as required.
Both patients and staff in healthcare facilities need voice communications. Traditionally, patient communications have been answered at the local nursing station down the hall, using patient/nurse call systems. Unfortunately, this often leads to long wait times and inefficient handling of many requests. For example, if a patient needs housekeeping or dietary services, an overloaded nurse may take quite some time to respond to the request. Most previous systems have limited the healthcare communications system problem to a strictly defined topology involving patient/nurse call communications systems hard-wired to local nursing stations.
In general, patient/nurse call systems allow patients to activate a “call” button or pick up a phone handset located in their room to contact a nurse or staff member at the nursing station located down the hall. The call button or phone handset normally triggers an audio connection between the patient's room and the nurse's station, whereupon the patient can speak directly with a nurse at the nurse station. Most patient/nurse call systems also allow input connections for emergency signaling devices, for example Bath Emergency Stations, Shower Stations, Hallway Indicator Lights, Code Blue Stations, Patient Beds and Call Cord devices. These patient room peripherals are also configured to notify the nurse's station serving the particular patient when activated.
The patient bed or the patient themselves may also be connected to a number of monitoring devices which can also communicate information directly to the nurses' station, for example, bed monitoring devices such as “brakes on”, mattress firmness, incontinence, patient presence, and patient weight. Physiological devices may also be used, for example, heart rate monitors, breathing monitors, patient temperature sensors, blood pressure monitors, EKG monitors, ventilators, and IV pumps. Other miscellaneous devices and/or monitors may also be present, for example, treatment and therapy devices that administer medication. Information from these systems may not only be displayed at a nurse station, but may also be configured to trigger an alarm or action item at the nurse station under certain conditions, for example if a patient's temperature gets to high.
In most prior art systems, the patient/nurse call system was hard wired directly to the single, local nurse station serving the particular patient location. Such a system had an extremely minimal ability to track and document patient requests. These systems lacked any capability to dispatch non-nursing personnel to a patient, or to dispatch other personnel to handle non-patient duties such as cleaning a room, repairing a bed, or doing preventative maintenance on a piece of equipment. Moreover, some existing systems will not directly route patient calls to a nurse. Thus, facilities have to staff the nurse station with sufficient personnel to respond to all patient calls. Unfortunately, many of the patient calls are unrelated to medical care or medical questions. By initially directing all patient calls, regardless of their nature, to the nurse station serving the patient location, nurses are often consumed with answering and responding to patient calls when other staff personnel could properly respond to the patient request. For example, a patient request for assistance walking to the bathroom could be answered by non-medical staff rather than a nurse. Even if the nurse does not have to perform the specific task, it has taken the nurse time to answer the call and locate or communicate with the appropriate personnel to respond. Moreover, there is little or no documentation of the request.
Research has shown that the response time to answer a patient call in this fashion averages about 1 minute. This is often due to the fact that nursing staff are busy responding to other patient calls that could be handled by other hospital personnel. Once received, the process of relaying the purpose of the patient call received at the nurse station to the appropriate person for response was to (a) seek and find the necessary caregiver; (b) seek and page the necessary caregiver; or (c) seek and tell someone else. Research also shows that the average time to complete a particular communication event in this manner is 1.8 minutes. Again, in these circumstances, there was little or no documentation of the event.
The traditional method for responding to emergency situations was also inefficient. Often, when an emergency situation developed, for example when a patient monitor detected a dangerous heart rhythm, the process of communicating the emergency code required numerous phone calls, encrypted paging, and overhead paging. These communication events were also often not documented.
Studies have also shown that patients recover faster when their surroundings are quiet and peaceful. Unfortunately, prior art systems that send nurse calls to the local nursing station or directly to the nurse are loud, and often include ringing phones, overhead pages, and nurses talking at volumes that can be heard by patients.
In addition to voice communications, additional information related to patient care must be communicated to facility staff. For example, information from emergency signaling devices, bed monitoring devices, and physiological devices must be efficiently communicated to the proper personnel. In addition, a medical facility must utilize systems to manage requests for patient transport, package management, requests for the food service department, maintenance work orders, bed management, pharmacy requests, and lab requests, just to name a few. These systems, however, are often separate computer systems that are not integrated into a facility's overall information system and do not provide efficient communication with the proper staff. Moreover, these systems do not provide adequate or real time tracking and logging of activity data, nor do they permit escalation of task requests.
With regard to patient transport, nursing traditionally performs all transfers and discharges by department. The standard process is for a nurse to seek and find a wheelchair, and transport patient from unit to unit or for discharge. This process can average over thirty minutes.
With regard to package management, traditionally a facility's package delivery system was either performed by an outside third party courier service or by the employee with the need.
With regard to the food service department, the following process is traditionally initiated to order and deliver a tray to a new admit or late tray request. The patient's doctor would write the diet order. The order was entered into the facility database by a secretary. The order would print in the food services office and a diet clerk would pull the order off the printer. The diet clerk would document any changes on a diet sheet and complete a meal ticket. The dietary clerk would then place the meal ticket in the window of the diet office. A dietary aide would pull the ticket and prepare the tray. The aide would then deliver the tray to the nursing station and the nurse would deliver to the patient.
With regard to maintenance work orders, the following process describes the general communication process performed from beginning of a maintenance work order assignment through completion. A request is received by phone/facsimile/relay through an employee at the facility operations office window. Depending on the priority or nature of the request, the request was either: (a) entered into the work order system for immediate printing and dispatch via a 2-way radio; (b) entered into a work order system for immediate printing and given to a supervisor once located; or (c) entered into the work order system for printing during the next day's routine printing. Depending on which action was chosen, a technician either (a) responded to radio dispatch, recording and procuring parts as needed in the facility operations storeroom completing the work order documentation upon return; (b) supervisor dispatched work order verbally, by page, by radio, or by overhead page, then continued as stated above after dispatch; or (c) received work order in bulk during the next morning, completing as stated above. The final communication step was completion of work orders with parts list documentation entered into the system by office and parts room staff. Research shows that the average response time to communicate a work order process from assignment to conclusion was approximately 30 minutes.
With regard to bed management, communication events seeking to admit a patient to a facility generally followed the following process. The ER, Operating Room or doctor's office phoned the Admitting Office for rooms STAT or based on unit census, the need became STAT. The communication event was routed as follows: The STAT call for room request was generated through the Admitting Office. The Admitting Office called housekeeping to clean a room. The housekeeping office would page the housekeeping supervisor and waited on a return call. After speaking with the housekeeping supervisor, the supervisor would page an aide to clean a room or actually walk the floors with an aide to find a specific room to begin cleaning. The supervisor would communicate this information to the housekeeping office. Usually the aide would return the page to the supervisor notifying of a specific room being cleaned. The housekeeping supervisor would call and notify the Admitting Office. The Admitting Office would then notify the requesting party of the actual room location. The final action was the Admitting clerk entering the patient data into the facility information system network. Research has shown this process averages twenty minutes.
With regard to lab requests, the traditional process of order entry involved nursing personnel entering lab orders into the facility information network (normally the clinical applications therein). The notification process regarding STAT/NOW orders involved paging or calling the Lab Tech, and would interrupt the Lab Tech working on pending orders.
With regard to pharmacy requests, the traditional process of order entry involved nursing personnel entering pharmacy orders into the facility information network (normally the clinical applications therein). The notification process regarding pharmacy orders involved paging or calling the pharmacy, and would interrupt the pharmacy Tech working on pending orders.
Prior patents that address healthcare communications systems focus on nurse call from a specific physical bed to a local nursing station, rather than permitting arbitrary relationships among patients, in beds on the nursing unit or elsewhere, equipment, and staff functions both local and in arbitrary geographic locations. In general, they deal with hierarchical, relatively stable relationships rather than dynamic tasking. Others dealing with patient telemetry do not take an integrated view of the room environment of the patient, or associate patient physiological information shown to staff with administrative and historical knowledge of the patient. The obvious drawbacks of the prior art systems and methods include inefficient communication of orders and tasks, lack of order and task assignment, lack of tracking and escalation, and lack of proper documentation.
Applicant's present invention overcomes the drawbacks and limitations in the prior art systems and methods and offers health care facilities a more efficient, secure, and patient oriented healthcare communication system and method capable of managing and supporting the services fundamental to a modern health care organization.